A framework for the design and implementation of Stop the Bleed and public access trauma equipment programs

Levy, Matthew J.; Krohmer, Jon R.; Goralnick, Eric; Charlton, Nathan P.; Nemeth, Ira; Jacobs, Lenworth M.; Goolsby, Craig

doi:10.1002/emp2.12833

Cited by 6 publications

(6 citation statements)

References 44 publications

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“…In preventable trauma-related deaths, inadequate hemorrhage control has been noted in three out of four cases (Beck et al, 2019), and use of bleeding control (B-Con) equipment such as tourniquets has been recommended in prehospital settings to control severe hemorrhage (Bulger et al, 2014). The Hartford Consensus and the "Stop the Bleed" program has recommended both educating the public in B-Con and placing B-Con kits in public areas (Jacobs et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…A need for research on optimal placement of B-con kits has been noted (Goralnick et al, 2020), but little research has been conducted. Some recommendations on B-con kit placement exist, unanimously recommending co-locating B-con kits with automated external defibrillators (AEDs) (Jacobs et al, 2015(Jacobs et al, , 2022Levy et al, 2022). Other recommendations include making kits easy to identify through signage, marking placement of kits in emergency plans, placing B-con material so it can be used within three minutes, and distributing B-con material throughout buildings.…”

Section: Introductionmentioning

confidence: 99%

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Where and how do people search for medical emergency equipment in public buildings?

Norrblom,

Prytz,

Jonson

2023

Proceedings of the Human Factors and Ergonomics Society Annual

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Exsanguinating trauma is a common cause of death. Placing bleeding control kits in public areas has been suggested as a countermeasure. Similarly, automatic external defibrillators (AEDs) are placed in public areas in case of cardiac arrests. Both severe bleeding and cardiac arrests require rapid care and people must be able to quickly find relevant emergency equipment. This study explores where and how people search for such equipment. Twenty participants wearing eye-tracking glasses searched for bleeding control kits and AEDs in a public building. The participants visually searched features such as signs with maps, written information, and other emergency equipment. The participants expressed elevators and staircases, open areas, entrances, and the reception to be places where medical emergency equipment would likely be placed. The results suggest that these features and places may be suitable for medical emergency equipment or directions.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Where and how do people search for medical emergency equipment in public buildings?

Norrblom,

Prytz,

Jonson

2023

Proceedings of the Human Factors and Ergonomics Society Annual

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“…As the leading cause of death from traumatic injury is blood loss, early recognition, appropriate intervention, and activation of the emergency medical system, are needed to reduce sequelae and mortality. The principles of Stop the Bleed (STB) offer individuals and populations a means to render care but require an appropriate educational approach and program accessibility for effective implementation [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Learner’s Stop the Bleed Outcomes Between Lay Instructor and Emergency Medical Services (EMS)-Trained Instructor Groups

Pellegrino,

Smith,

Nolan

et al. 2023

Cureus

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Background: One of the most utilized Stop the Bleed courses, the “Bleeding Control Basic (BCon) course v. 1.0,” requires instructors to have a specific healthcare license or pre-hospital credential (e.g., physician or paramedic) or specific emergency medical services (EMS) instructor certification and have completed the BCon provider course. This requirement provides a level of expertise in instructors but limits the potential workforce for sharing life-saving knowledge and skills. Other Stop the Bleed courses, such as the American Red Cross First Aid for Severe Trauma (FAST) course, do not have this requirement. This raises questions pertaining to the learners' outcomes between those facilitated by instructors with and without healthcare licenses or credentials. Methods: Learners' outcomes for applying a tourniquet (skill), knowledge (cognitive), and Intention to Aid (attitude for behavior) were compared between those taught by lay instructors and EMS-trained (emergency medical technician or paramedic) instructors. All were trained as new instructors in the FAST program. Results: For the study’s primary outcome, all of the learners (n=135) properly applied a tourniquet to a simulated leg injury at the end of the training based on video evidence (skill). Learners in the EMS-trained instructor groups (n=84, mean age 25.5 years, 68% female), who were older and had more education, scored significantly higher on knowledge of tourniquet use on the Stop the Bleed Educational Assessment Tool (SBEAT) (mean=90.0 vs. 83.9 on a scale of 0-100, p=0.001) with a small effect size than the lay instructor group (n=51, mean age 16.6 years, 88% female). There was no statistical difference in attitude toward helping behaviors in a bleeding emergency between the two groups on the Intention to Aid (I2A) survey. Implications: Lay instructors and EMS-trained instructors performed comparably in facilitating a widely available Red Cross Stop the Bleed course. Lay experience with tourniquets should not disqualify individuals from being a Stop the Bleed instructor. Using a standard curriculum with instructor development offers a way for people with and without an EMS background to teach life-saving competencies effectively.

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“…16,17 The national StopTheBleed campaign, which has taught more than 3 million Americans basic bleeding control methods, such as tourniquet use, is another example of wartime lessons informing the public's well-being. 18,19 In a nod to transfer the "leave no one behind" approach to civilians, the DoD Combat Casualty Care Research Program helped initiate and fund the Multi-Institutional, Multidisciplinary Injury Mortality Investigation in the Civilian Setting or MIMIC study. MIMIC will analyze prehospital death in different areas of the country and help identify ways to improve the survival of civilians injured in accidents, intentional acts of violence, and natural disasters.…”

mentioning

confidence: 99%

“…The MISSION ZERO Act which provides federal funding for military-civilian partnerships in trauma care was signed into law in 2019, and Public Law 115-92 compels the U.S. Food and Drug Administration to expedite the availability of medical products for the emergency care of military personnel was enacted in 2017 16,17 . The national StopTheBleed campaign, which has taught more than 3 million Americans basic bleeding control methods, such as tourniquet use, is another example of wartime lessons informing the public’s well-being 18,19 . In a nod to transfer the “leave no one behind” approach to civilians, the DoD Combat Casualty Care Research Program helped initiate and fund the Multi-Institutional, Multidisciplinary Injury Mortality Investigation in the Civilian Setting or MIMIC study.…”

mentioning

confidence: 99%

Leave no One Behind

Rasmussen,

Coleman

2023

Annals of Surgery

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A framework for the design and implementation of Stop the Bleed and public access trauma equipment programs

Cited by 6 publications

References 44 publications

Where and how do people search for medical emergency equipment in public buildings?

Where and how do people search for medical emergency equipment in public buildings?

Learner’s Stop the Bleed Outcomes Between Lay Instructor and Emergency Medical Services (EMS)-Trained Instructor Groups

Leave no One Behind

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